Device breathes life into H1N1 patient

NEW DELHI: A machine traditionally used to allow gas exchange outside the body during a bypass surgery, holds out hope for swine flu patients . It can alleviate acute respiratory distress, responsible for death in most swine flu cases. The virus has claimed over 400 lives in India this year.

Extracorporeal Membrane Oxygenation (ECMO) is a machine which acts like an artificial lung by removing carbon dioxide from the blood and adding oxygen outside the body. Doctors at Sir Ganga Ram Hospital have used it successfully to save a 54-year-old man suffering from swine flu.

Dr Arup Basu, vice chairman of the hospital's pulmonolgy department, said Rajesh Kumara, a Dwarka-based industrialist, was referred to them by another private hospital in Dwarka on January 30. "He was suffering from severe respiratory distress and de-saturation. He could not breathe or walk and had to be admitted to the ICU. We put him on high-frequency ventilator support and antibiotics but it failed to improve his oxygenation. We then put him on ECMO on February 7 as a last-ditch effort," said Basu. He said the patient remained on ECMO for a record 24 days, and weaned off gradually after his natural lungs showed signs of improvement.

The patient's family were all smiles. "In the last one month, ever since he got admitted, there have been many trying moments. Rajesh suffered from secondary infection and there was risk of haemorrhage if the blood clotted. It is the doctors' effort and god's grace which has seen him through," said Ranjana, the patient's wife.

Doctors said acute respiratory distress syndrome is the most common cause of death among swine flu patients. "We could save Kumar only because the lungs were given rest till the infection subsided. Usually, such patients give way due to lack of oxygenation in the blood," said Dr Arun Mohanty, consultant cardiologist. But, he added that ECMO cannot be used in patients with irreversible respiratory failure.

The hospital authorities said the cardiac anaesthesia team headed by Dr Arun Maheshwari worked round the clock to save the patient. "ECMO has proved to be lifesaver in this difficult case of swine flu. I hope this important technology will help in saving the lives of many more critical patients in future," said Dr D S Rana, chairman, board of management at SGRH.

The use of ECMO to save swine flu patient is new in India but it has been done extensively abroad. A study published in The Journal of the American Medical Association ( JAMA) in 2011, said an investigation at a UK hospital found that twice as many non-ECMO-referred patients died on not being referred for ECMO during 2009-10.